Kontakt 2014, 16(1):e17-e23 | DOI: 10.1016/j.kontakt.2013.11.001

The importance of nursing standards: elements to create a standard for sheath decannulation according to EBPNursing - Original article

Ludmila Klemsováa,*, Katarína Žiakováb
a Ostravská univerzita v Ostravě, Lékařská fakulta, Ústav ošetřovatelství a porodní asistence, Ostrava
b Univerzita Komenského v Bratislave, Jesseniova lekárska fakulta v Martine, Ústav ošetrovateľstva, Martin

Diagnostic coronarography and coronary interventions have become widely accepted procedures in patients with ischemic heart disease, in the acute, chronic, as well as diagnostic stages. The interventions on coronary arteries are closely connected with diagnostic catheterization and deal with stenoses of coronary arteries. The diagnostic and interventional catheters used for the procedure are inserted through the femoral or radial artery. Decannulation of the sheath following the femoral and radial access is an important part of the procedure. This review article analyses the available literary sources, with the aim of determining the possibilities of standardization of the specialized nursing care provided for patients requiring decannulation of the sheath from the arteria radialis, or femoralis, following left-side coronary catheterization. The presented paper has been drawn up on the basis of a review of expert articles presented in freely accessible databases in the period between 2000 and 2012. The nursing standards for decannulation of the sheath obtained from the links to foreign literature often arise from the conclusions of nursing research (EBP). Standards concentrate on the means and length of compression of the arteria femoralis and arteria radialis; furthermore, they specify the compression device for the respective blood drainage area and maintaining the safety and comfort of the patient. Correctly set standards eliminate the rate of complications (haematoma, bleeding), in relation for example to the type of compression applied on the artery, or to nursing staff trained in compression techniques. The nursing standard is an important part of the procedure, contributing to a reduction in complications and an improvement in the patient's comfort, and has an important platform, especially abroad. Significant elements for the creation of standards and defining the correct criteria according to the EBP standard were analysed from the available sources.

Keywords: nursing; radial; femoral; compression; standard

Received: August 30, 2013; Accepted: November 18, 2013; Published: March 21, 2014  Show citation

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Klemsová L, Žiaková K. The importance of nursing standards: elements to create a standard for sheath decannulation according to EBP. Kontakt. 2014;16(1):e17-23. doi: 10.1016/j.kontakt.2013.11.001.
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References

  1. Agostoni P, Biondi-Zoccai GG, de Benedictis ML, Rigattieri S, Turri M, Anselmi M et al. Radial versus femoral approach in percutaneous coronary and interventional procedures: systematic overview and metaanalysis of randomized trials. Journal of the American College of Cardiology 2004;44(2):349-56. Go to original source... Go to PubMed...
  2. Gall S, Tarique A, Natarajan A, Zaman A. Rapid ambulation after coronary angiography via femoral artery access: a prospective study of 1,000 patients. Journal of the Invasive Cardiol 2006;18(3):106-8.
  3. Smith TT, Labrilola R. Developing best practice in arterial sheath removal for registered nurses. Journal of Nursing Care Quality 2001;16(1):61-7. Go to original source... Go to PubMed...
  4. Tagney J, Lackie D. Bed-rest post-femoral arterial sheath removal - What is safe practice? A clinical audit. Nursing in Critical Care 2005;10(4):167-73. Go to original source... Go to PubMed...
  5. Klemsová L, Zvolánková E, Zarembová J, Olšová M, Pavelková R. Časné vyjmutí zavaděče z arteria femoralis registrovanými sestrami po diagnostické koronarografii. Cor et Vasa 2010;52(1-2):86-7.
  6. Liew R, Lidder E, Gorman M, Gray A, Dealer, Knight C. Very low complication rates with a manual, nurse-led protocol for femoral sheath removal following coronary angiography. European Journal of Cardiovascular Nursing 2007;6(4):303-7. Go to original source... Go to PubMed...
  7. Singleton ME. Comparing the Effects of Two Types of Groin Dressing Securements on Skin Integrity. Hematoma; 2003. [online] [cit. 2013-11-13]. Dostupné z: http://multimedia.3m.com/mws/mediawebserver?mwsId=SSSSSufSevTsZxtUMY_eO8mSevUqevTSevTSevTSeSSSSSS--&fn=70-2009-4553-6.pdf
  8. Steffenino G, Dutto S, Conte L, Dutto M, Lice G, Tomatis M et al. Vascular access complications after cardiac catheterisation: A nurse-led quality assurance program. European Journal of Cardiovascular Nursing 2006;5(1):31-6. Go to original source... Go to PubMed...
  9. Schiks I, Schoonhoven L, Verheught F, Aengevaeren W, Vanachterberg T. Performance evaluation of arterial femoral sheath removal by registered nurses after PCI. European Journal of Cardiovascular Nursing 2007;6(3):172-7. Go to original source... Go to PubMed...
  10. Gonzales L, Field W, McGinty J, Gallo A-M. Quality Improvement in the Catheterization Laboratory: Redesigning Patient Flow for Improved Outcomes; 2010. [online] [cit. 2012-12-10]. Dostupné z: http://ccn.aacnjournals.org/content/30/2/25.full. doi: 10.4037/ccn2010832
  11. Bernát I, Koza J, Pešek J, Šmíd M. Radiální přístup u koronárních a nekoronárních katetrizací a intervencí. Cor et Vasa 2009;(1):59-63. Go to original source...
  12. Rao SV, Ou, TY., Wang MT, Roe RB, Rumsfelda JS. Peterson ED. Trends in the Prevalence and Outcomes of Radial and Femoral Approaches to Percutaneous Coronary Intervention. A Report From the National Cardiovascular Data Registry. JACC: Cardiovascular Intervention 2008;1(4):379-86. Go to original source...
  13. ÚZIS ČR. Přehled vybraných kardiovaskulárních intervencí v ČR 2010; Praha.
  14. Cooper CJ, El-Shiekh RA, Cohen DJ, Bleasing L, Burket MW, Basu A et al. Effect of transradial access on quality of life and cost of cardiac cateterization: a randomized comparison. American Heart Journal 1999;138(1): 430-6. Go to original source... Go to PubMed...
  15. Amoroso G, Sarti M, Bellucci R, Puma FL, D'Alessando S, Limbruno U et al. Clinical and procedural predictors of nurse workload during and after invasive coronary procedures: the potential benefit of a systematic radial access. Eur J Cardiovasc Nurs 2005;4(3):234-41. Go to original source... Go to PubMed...
  16. Roussanov O, Wilson SJ, Henley K, Estacio G, Hill J, Dogan B et al. Cost-effectiveness of the radial versus femoral artery approach to diagnostic cardiac catheterization. Journal Invasive Cardiology 2007;19(8):349-53. Go to original source...
  17. Slagboom T, Kiemeneij F, Laarman GJ, van der Wieken R. Outpatient coronary angioplasty: feasible and safe. Catheter and Cardiovascular Intervention 2005;65(3):421-7. Go to original source... Go to PubMed...
  18. Jolly SS, Amlai S, Hamon M., Yusuf S., Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: A systematic review and meta-analysis of randomized trials; 2008. [online] [cit. 2012-10-11]. Dostupné z: http://www.ahjonline.com/article/S0002-8703(08)00742-4/abstract.
  19. Carrington CH, Mann R, El-Jack S. An Accelerated Hemostasis Protocol following Transradial Cardiac Catheterization Is Safe and May Shorten Hospital Stay: A Single Center Experience. Journal of Interventional Cardiology 2009;22(6):571-5. Go to original source... Go to PubMed...
  20. Rathore S, Stables RH, Pauriah M., Hakeem A, Mills JD, Palmer ND et al. A randomized comparison of TR band and radistop hemostatic compression devices after transradial coronary intervention. Catheterization and Cardiovascular Interventions 2010;76(5):660-7. Go to original source... Go to PubMed...
  21. Steffenino G, Benedetto MD, Fabrizi G, Baralis M, Tomatis A, Mogna M et al. Implementation of radial arterial access for cardiac interventions: a strong case for quality assurance protocols by the nursing staff. Journal of Cardiovascular Medicine 2011;12(2): 116-21. Go to original source... Go to PubMed...
  22. Bernát I, Koza J, Pešek J, Šmíd M, Brůhová H, Štěrbáková G et al. Srovnání nízké a standardní dávky nefrakciovaného heparinu u transradiálních diagnostických srdečních katetrizací. Intervenční a akutní kardiologie 2010;3:130-4.
  23. Zeleníková R, Jarošová D. Úvod do problematiky ošetřovatelství založeného na důkazech (Evidence Based Nursing). Kontakt 2013;15(1):7-13. Go to original source...
  24. Gurková E, Žiaková K. Ošetrovatelská diagnostika v kontexte praxe založenej na dôkazoch. Kontakt 2009;11(I):32-7. Go to original source...
  25. Papoušková P, Otásková J, Brabcová I. Vyhodnocení kvality ošetřovatelské péče v českobudějovické nemocnici. Kontakt 2009;9(1):8-18. Go to original source...